胺碘酮与心律平对阵发性心房颤动疗效的比较

目的：对比观察胺碘酮和心律平治疗阵发性心房颤动的疗效与安全性。方法：56例频繁发作的阵发性房颤患随机分为胺碘酮组(28例)和心律平组(28例)。胺碘酮用法为：0．2g，每天3次，7～10d；0．2g，每天2次，1wk；维持量0．2g，每天1次或0．2g，每2天1次。心律平：0.15g，每天3次或0．15g，每天4次，14d；维持量0．1g，每天3次。服用负荷量期间每周就诊1次，维持量期间每月就诊1次。结果：随访6mon，胺碘酮组和心律平组分别有4例和2例因出现难以耐受的副作用而终止治疗，无危及生命的副作用。胺碘酮组总有效率82．1％，心律平组为57．1％(P＜0．05)。结论：胺碘酮对阵发性心房颤动的疗效高于心律平，但其长期疗效可能会受到心脏外副作用的影响。

Comparison of efficacy and safety of oral amiodarone and propafenone in patients with paroxysmal atrial fibrillation

AIM: To compare the efficacy and safety of amiodarone and propafenone in the treatment of paroxysmal atrial fibr illation (AF). METHODS: The population consisted of 56 consecut ive patients (age 39-72 years, 37 male) with recurrent symptomatic atrial fibri llation. Those patients were randomized to amiodarone group (n=2 8) or propafenone group (n=28). Usage of amiodarone: 0.2 tid within seven to ten days, 0.2 bid within seven days. The maintain dose was 0.2 qd or 0.2 qod. Usage of propafenone: 0.15 tid or qid within two weeks. The maintain dose was 0.1 tid. Follow-up evaluations were conducted at 1, 2 and 3 weeks, and 4-week intervals thereafter. RESULTS: Duration of following up was 6 months. Four patients treated with amiodarone, a nd two with propafenone discontinued therapy due to adverse effects. There was n o life-threatening adverse effects .The whole effective rate was 82.1 % in a miodarone group and 57.1 % in propafenone group (P< 0.05 ). CONCLUSION: Amiodarone was more effective than propafenone in treatment of paroxysmal AF, though its long-term efficacy was limited by noncar diac adverse side effects.